A study on the influencing factors of the public’s willingness to donate funds for critical illness crowdfunding projects on network platforms

As an emerging charity model, critical illness network crowdfunding provides a source of funds for some critically ill patients in China who have difficulty paying their high treatment costs by themselves. This study aims to investigate the influencing factors of the public’s willingness to donate to critical illness crowdfunding projects on Internet platforms. From a perspective combining the technology acceptance model and the theory of planned behavior, a complex and comprehensive structural equation model is proposed. We randomly selected 1,000 members of the public in China and empirically verified the study framework through structural equation modeling (SEM) based on 710 valid questionnaires. The results show that the public’s donation willingness and the social distance to a critical illness crowdfunding project on an online platform positively affect the public’s donation behavior, and donation attitude positively affect donation willingness; perceived usefulness and empathic concern positively affect the public’s donation attitude, which in turn affects its donation willingness. This study confirms that members of the public are more likely to help people who have similar demographic factors or people who are similar to themselves and have the same values, i.e., people who have a close social distance. It innovatively proposes and verifies the hypothesis that empathic concern can significantly positively affect users’ perceived usefulness and donation attitude. Strong empathic concern triggers donation willingness and behavior.

We hope that the revision of the manuscript and our reply will be enough to make our manuscript suitable for publication in PLoS ONE.
We look forward to hearing from you at your earliest convenience.

Yours sincerely, Lu Chen
Manuscript PONE-D-21-03866 is a study of the influencing factors of the public willingness to donate funds to critical illness via crowd-funding platforms. They use a well established framework of structural equation modeling (SEM) evalute path coefficient for 14 well grounded hypotheses. 1) The manuscript would benefit from exploratory data analysis (visual). For example, it would be illustrative to see the distributions of potential variables to confirm their "normality". Of course in this particular case the variables are categorigal and SEM can be used only approximately, which should mentioned in the analysis.Another example would be visualing correlation between varios external variables (gender, age and income) and potential variables.
2) It would be great to evaluating the effect of gender, age and income level on the path coefficients. What if there is significant divergence there? For example if between two groups one has positive effect and the other negative, the overall result could be close to zero, as in H1. Overall after a minor revision the manuscript is suitable for publication.

Our replies:
Thank you very much for your careful review and constructive suggestions with regard to our manuscript. Thoses comments are very helpful for us to revise and improve our paper.
There are two main aspects of reviewer 1's comments, which are to be answered one by one.
1. For the first suggestion, we have observed the distributions of potential variables and determined that they are all approximately "normality". Of course, in this special case, variables are classified, SEM can only be used approximately, We also emphasized this sentence in the revised manuscript(The details are shown from line 503~505) A-Donation attitude；C-Empathic Concern；E-Perceived usefulness；G-Platform trust； J-Interactivity；k-Donation willingness；L-Social distance；M-Donation behavior 2. For the second question, we have evaluated the effects of gender, age and income level on the path coefficients. Through grouping observation, We find that there is no significant difference in the overall model path through grouping observation, and some paths, such as men, are negative, but not significant. The above reasons are due to the differences of samples, that is, there are differences in cognition and behavior among different groups.
We hope that the corrections will meet with your concerns.
Special thanks to you for your good comments. This is obviously an interesting article. However, there are few issues that need to looked at.
Find the following: 1. For example, the article mentions both "Internet +" donations and "Internet donations".
How different are these two concepts?
2. Besides, it would have been helpful especially for readers who may not be conversant with this model of donation to know exactly what "Internet +" is. Is it generally known or it's restricted to only the study area?
3. It may be helpful to provide distinctions among the 12 latent variables that were considered. How different are they from each other? 4. It was also not to clear the target of the recommendations. The suggestion is for the recommendations to be targeted at particular person/institution etc.

Our replies:
Thank you very much for your careful review and constructive suggestions with regard to our manuscript. Thoses comments are very helpful for us to revise and improve our paper.
There are three main aspects of reviewer 2's comments, which are to be answered one by one.
1. The first and second questions you mentioned, especially about the articles both "Internet +" donations and "Internet donations", we also found this kind of problems when we checked them. There is no obvious difference between the two, but it does cause ambiguity to readers. In the revised manuscript, there has been a unified way of expression, namely "Internet donations". Thank you for your advice.
2. There are mainly eight variables in the revised and improved model. No matter the previous 12 variables or the current 8 variables, they are mainly based on the two classic models in the field of consumer behavior research--TAM and TPB.
The reason is that TAM can explore the trade-off process when the public uses the platform as a system function. As a general model, TAM only provides two cognitive concepts that affect individuals' willingness to accept technology, namely perceived usefulness and perceived ease of use. It does not explain or limit the external variables that affect the usefulness and ease of use in specific application situations, while TPB combines various variables, including the public's attitude towards behavior and the influence of others.
Therefore, in the TAM model, in order to better explain the public's willingness to donate and decision-making behavior under the specific circumstances of the critical illness crowdfunding platform, the public's trust in the platform is taken as an important premise of perceived usefulness, which is based on the design of the interactive mechanism provided by the platform.
TAM model itself includes four variables: perceived usefulness, donation attitude, donation willingness and donation behavior.
Personal empathy is also added as a variable of personal factors to measure the public's willingness to donate to the crowdfunding projects for major diseases on the Internet platform.
In addition, in the part of TPB model, the TPB holds that the behavior of an individual is not always controlled by his or her own will. Rather, the individual's behavior is affected by internal and external factors. Attitudes and standardized responses to performed situations will change the individual's behavior, so we added the variable of social distance.
Therefore, there are eight variables.
(The details are shown from line 108~372) 3. For the fourth question, thank you very much for your suggestions, including your suggestion that the suggestion is for the recommendations to be targeted at particular person / institution, etc We have readjusted this part according to your suggestions, which can be divided into suggestions for the government, platforms and help-seekers.
(The details are shown from line 611~708)

Reviewer #3:
The authors are quite ambitious to use 45 variables with 12 latent factors in a SEM (n = 710) to explain the behaviour related to crowdfunding projects on network platform in China.
However, the proposed model failed to fulfil the minimum criteria for adequate model fit, with merely GFI = 0.788, CFI = 0.835 and X2/df = 3.909 (p. 35-36), i.e. the entire manuscript needs to be re-written, with revised research questions, hypothesis, theoretical framework, and data analysis.
More importantly, the theoretical framework is very weak, the authors only list out various theories and perspectives (p. 12-23) but without showing any linkage with reference to the existing literature.
The conclusions and recommendations, such as urging for more governmental supervision, by using legal framework and blockchain technology for further government monitoring etc., did not based on the results/empirical findings.
Hence, I do not think the current form of manuscript is suitable for publication. There are major flaws in the research design and data analysis methods. There is also lack of theoretical contribution.

Our replies:
Thank you very much for your careful review and constructive suggestions with regard to our manuscript. Thoses comments are very helpful for us to revise and improve our paper.
There are three main aspects of reviewer 3's comments, which are to be answered one by one.
1. The first question is that the proposed model does not meet the fitting standard.
With a little explanation of this situation, in the first draft, there were 12 variables considered at that time, and the whole model was more complex. Therefore, the requirements for individual index data were lowered, only close to 0.9, but not more than 0.9. It was really worth reflecting that they were reported as model fitting results.
To solve this problem, in this draft, our revision ideas and specific measures are as follows: Reorganize variables and models. In the original TAM model, a few variables, such as perceived ease of use, which are not suitable for current situation discussion, are eliminated.
In traditional TAM, the higher the ease of use of a critical illness crowdfunding platform perceived by the public is, the higher the usefulness and effectiveness of the platform perceived by the public. However, the ease of use of the Internet platform has been very high after years of development, So the variable of the ease of use will not be considered in this study. At the same time, considering that both subjective norm and social distance In the process of revising the manuscript, we still rescreened the relevant literature, but the relevant literature is still not rich.
(1) There are few empirical studies on this topic in China, and there are few high-level literatures; (2) Foreign related literature is not much, some donation articles mainly focus on organ donation; (3) Although there are not many high-level literatures for reference, it is still a social phenomenon and hot issue of great research significance. Therefore, we start from the perspective of consumer behavior and choose the classic TAM and TPB models. The variables commonly used in these two models are relatively fixed, and the literatures on these two models are very common, Therefore, there is not too much theoretical elaboration in the article, and the article introduces the theory and literature basis of path hypothesis in detail. As far as the current structure is concerned, both the literature review and the path hypothesis are fairly long. If the reviewers feel that it is still necessary to explain the TAM and TPB variables in detail, we will complete it as soon as possible.
3. The third question is about policy recommendations. In this draft, we made the following adjustments: (1) Readjust the structure and level of the proposal part. It can be divided into for government, platforms and help-seekers; (2) As for the government's proposal you mentioned, which has no basis, we have also made an explanation and response. The proposal to strengthen government supervision, such as improving legislation, is based on the review of the current laws and government policy reports. The reason why we didn't launch the discussion is that the theme of the discussion is the influencing factors and paths of donation behavior. Of course, if we all agree that we should consolidate here, we will continue to work hard.
We hope that the corrections will meet with your concerns.
Special thanks to you for your good comments.

Response to Journal Requirements
Dear Editor, I'm very glad to receive your email. It's very nice of you to proofread our manuscript. The following part is about some of the necessity of Journal Requirements.
According to your suggestions, we have responded one by one and adjusted the corresponding parts in the revised manuscript, and our replies are marked in yellow.
Thank you again for your hard work.
If there is anything wrong, please let me know.
Thank you.
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Thank you for your suggestion. The revised manuscript has been received according to the style requirements of PLoS One to arrange the chapters and layout. If there is anything wrong, we will improve it according to the requirements of the journal.
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We have uploaded the minimum anonymous data set, which includes the values behind the reported average, standard deviation and other measures, as well as the values used to build the graph(in Table 1~Table 5) 4. PLOS requires an ORCID iD for the corresponding author in Editorial Manager on papers submitted after December 6th, 2016. Please ensure that you have an ORCID iD and that it is validated in Editorial Manager. To do this, go to 'Update my Information' (in the upper left-hand corner of the main menu), and click on the Fetch/Validate link next to the ORCID field. This will take you to the ORCID site and allow you to create a new iD or authenticate a pre-existing iD in Editorial Manager. Please see the following video for instructions on linking an ORCID iD to your Editorial Manager account: https://www.youtube.com/watch?v=_xcclfuvtxQ Thank you for your reminding. Our three corresponding authors have updated their ORCID ID, which are: Fan Luo https://orcid.org/0000-0002-8487-0200 Wanshi He https://orcid.org/0000-0001-8109-6566 Heng Zhao https://orcid.org/0000-0002-7344-4329 5. We note that Figure 3 in your submission contain map images which may be copyrighted.